CPT 96373: Intra-arterial Medication Administration
Medicare pays $21 and commercial payers pay $60 on average nationally for this procedure.
CPT code 96373 describes administration of a medication or other substance via an artery for therapeutic, prophylactic, or diagnostic purposes; this is an intra-arterial medication administration procedure typically performed by a clinician in an outpatient interventional suite, hospital inpatient setting, or specialized catheterization lab and is a vascular-directed parenteral service involving arterial access and drug delivery.
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National Reimbursement Benchmarks
Across national payers, Medicare’s mean rate of $20.50 for CPT 96373 sits considerably below the BUCA commercial average mean of $60.30, indicating a sizable gap between public reimbursement and that commercial cohort. Blue Cross Blue Shield and BUCA show the highest mean levels ($85.30 and $60.30 respectively), while Aetna and Medicare are clustered at lower means ($20.60 and $20.50), with Cigna and UnitedHealth Group in the $30 range. This highlights a clear separation between Medicare pricing and several commercial payers’ higher average reimbursements.
Dispersion measured by the interquartile range (P75 minus P25) varies meaningfully: Blue Cross Blue Shield has the widest IQR at $48.30 (P75 $108.20 minus P25 $59.00), followed by UnitedHealth Group at $17.40, Cigna at $19.80, and BUCA at $33.00. Aetna exhibits the tightest spread with an IQR of $4.10. These differences suggest Blue Cross Blue Shield reimbursement is the most variable across geographies or contracts, while Aetna’s rates are relatively consistent.